Most Relevant Information
Provider Data
| NPI Number: | 1003440900 |
| Provider Name: | KAILEY HYATT |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/28/2020 |
| Last Updated: | 02/28/2020 |
Provider Practice Location
31772 CASINO DR STE B
LAKE ELSINORE
CA
925304502
Practice Location Phone/Fax
| Phone: | 9516749400 |
| Fax: | 9516749486 |
Provider Mailing Location
31772 CASINO DR STE B
LAKE ELSINORE
CA
925304502
Provider Mailing Phone/Fax
| Phone: | 9516749400 |
| Fax: | 9516749486 |